Articles of Interest

Just Off Insular Senate Floor, Life of the Uninsured Intrudes

WASHINGTON, Nov. 24 — When senators debate health care, they usually speak in abstract terms about soaring health costs and the plight of the uninsured.

But just 20 feet from the Senate chamber is a young man who knows those problems all too well from personal experience. The man, Sergio A. Olaya, runs the Capitol elevators on which the senators ride. Whenever the Senate is in session, he is on duty.

Mr. Olaya, 21, is struggling with $255,000 of medical bills incurred by his mother before she died in April from an aggressive form of brain cancer.

A local hospital and its collection agency have been hounding him in an effort to collect from his mother’s estate, Mr. Olaya said. To pay the bills, he is selling the Maryland home where he lived with his mother, Clara Ines Olaya, 61.

His experience highlights the problems of the uninsured, from which members of Congress are usually insulated. The leading Democratic presidential candidates say all Americans should have coverage as good as what Congress has.

As a government employee, Mr. Olaya has health insurance. But his mother, like 47 million other Americans, was uninsured.

“I wonder how many senators have been in the elevator with Sergio, talked to him, shared a smile with him, but had no idea of the terrible burden he and his mother were carrying,” said Senator Richard J. Durbin of Illinois, the Senate Democratic whip, who learned of Mr. Olaya’s problems from an aide.

In an interview, Mr. Olaya said: “I’m just a college kid. I don’t have financial support from anyone. Paying $255,000 for medical bills derails my ability to pay for college.”

Senators have access to a wide range of insurance options through the Federal Employees Health Benefits Program. Congress has its own “attending physician” — actually, a team of 5 doctors and 14 nurses who work in the Capitol and nearby Congressional office buildings. Lawmakers can fill prescriptions at a small pharmacy in the Capitol. For more serious problems, they can use nearby military hospitals.

But Congress is far from agreement on any comprehensive proposals to help the uninsured. Even legislation to cover children has been caught up in a furious battle with President Bush over the proper role of government in providing insurance.

Senators are not normally exposed to the fears that strike many workers as employers reduce health benefits and insurers increase premiums year after year. Annual increases of 20 percent or more are not unusual for small businesses. The National Federation of Independent Business, a lobby for small business owners, says health costs are their top concern.

Since 2000, the number of uninsured, as reported by the Census Bureau, has increased by 8.6 million, or 22 percent. Some private studies suggest that one in three Americans under the age of 65 may have been uninsured at some time in the last two years.

“The truth is, almost every family is at risk because of a fraying health care safety net,” Mr. Durbin said. “Almost all of us could be one pink slip, one election, one bad diagnosis or one serious accident away from a health and economic disaster. This affects Sergio, a member of our Senate family. It affects all families.”

One lawmaker, Senator Sherrod Brown, Democrat of Ohio, has refused to accept the health insurance available to members of Congress. He says he will not take it until all Americans have access to affordable coverage.

Former Senator John Edwards, a candidate for the Democratic presidential nomination, said, “There is no excuse for politicians in Washington having health care when America has no health care.”

Mr. Edwards has been conveying that message to Iowa voters in 30-second television commercials. On his first day in office, he said, he will “submit legislation to end coverage for the president, all members of Congress and all senior political appointees in the legislative and executive branches of government on July 20, 2009 — unless Congress has enacted universal health insurance.”

One of his rivals for the nomination, Senator Hillary Rodham Clinton of New York, said she would “give all Americans the same set of insurance options that their members of Congress have.” This, she said, could be done “without any new bureaucracy.”

Another Democratic presidential contender, Senator Barack Obama of Illinois, said that under his proposal for universal coverage, everyone would have access to “health care that is as good as the health care that I have as a member of Congress.”

While waiting for such coverage, many Americans will wrestle with debts like those facing Mr. Olaya, the Senate elevator operator. He had been a student at the University of Delaware, but said he would not return until he paid his mother’s medical bills.

His mother, an expert on health and nutrition, was born in Colombia, received a master’s degree from Stanford in 1981 and became a United States citizen in 1994. She had health insurance in most of her jobs over the last 20 years, at the Centers for Disease Control and Prevention, the United States Agency for International Development, Unicef and other organizations.

But she had been unemployed and uninsured since December.

Mrs. Olaya had applied for a new federal job. When the job offer finally came in March, her son said, she had just suffered a stroke and could not get out of bed to answer the telephone. In another month or two, she might have had health coverage through her new job. In another four years, she would have been eligible for Medicare.

“Instead,” Senator Durbin said, “she had the bad luck and bad timing to fall through one of the gaping holes in America’s unraveling health care safety net. Now her only child, her son, is paying the price.”